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Human Physiology 2234 > Unit 5 Pulmonology > Flashcards

Unit 5 Pulmonology Flashcards

1
Q

Organs of the Respiratory System

A 
Nose
Pharynx
Larynx
Trachea
Bronchi
Lungs
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2
Q

Functions of the Nose

A

Warm, clean, and humidify air
detect odor
resonating chamber for voice amplification

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3
Q

Superior Half of the Nose

A

Bony and cartilaginous supports

nasal bones medially and maxillae laterally

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4
Q

Inferior Half of the Nose

A

Bony and cartilaginous supports

lateral and alar cartilages

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5
Q

Ala Nasi

A

flared portion of the nose shaped by dense CT, forms lateral wall of each nostril

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6
Q

Function of cilia of respiratory epithelium

A

sweep debris-laden mucus into pharynx to be swallowed

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7
Q

Erectile tissue of inferior concha (Nose)

A

venous plexus that rhythmically engorges with blood and shifts flow of air from one side of fossa to the other once or twice an hour to prevent drying

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8
Q

Spontaneous epistaxis

A

Nosebleed

most common site is inferior concha

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9
Q

Lower Respiratory Tract Structures

A 
Larynx
Trachea
Primary Bronchi
Secondary Bronchi
Tertiary Bronchi
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10
Q

Visceral pleura is located

A

On the Lungs

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11
Q

Parietal pleura is located

A

Lines Rib Cage

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12
Q

Functions of the Pleural cavity

A 
Reduce Friction
Create Pressure Gradient
*Lower Pressure assists lung inflation
Compartmentalization
*Prevents the spread of infection
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13
Q

Breathing

A

Pulmonary Ventilation

one cycle of inspiration and expiration

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14
Q

Quiet Respiration

A

At Rest

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15
Q

Forced Respiration

A

Occurs during exercise

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16
Q

Flow of Air in and out of lungs requires

A

a pressure difference between air pressure within lungs and outside body

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17
Q

Respiratory Muscles

A 
Diaphragm
Scalenes
External and Internal Intercostals
Pectoralis Minor
Sternocleidomastoid
Erector Spinae
Abdominals
Latissumus Dorsi
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18
Q

Diaphragm

A

Dome-Shaped
separates Thoracic and Abdominal Cavity
Contraction Flattens the Diaphragm

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19
Q

Scalenes Function

A

Hold the first pair of ribs stationary

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20
Q

External and Internal Intercostals function

A

stiffen thoracic cage; increases diameter

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21
Q

What muscles are used in forced Inspiration

A

Pectoralis minor
sternocleidomastoid
erector spinae muscles

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22
Q

What muscles are used in forced Expiration (Sing, Cough, Sneeze)

A

Abdominals and Latissimus Dorsi

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23
Q

Neural control of breathing requires

A

Repetitive stimuli from the brain

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24
Q

What controls unconscious breathing?

A

Neurons in the medulla Oblongata and Pons

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25
Q

Voluntary control of breathing is controlled by

A

Motor Cortex

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26
Q

Which neurons fire during Inspiration

A

Inspiratory Neurons

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27
Q

Which neurons fire during forced expiration

A

Expiratory neurons

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28
Q

Fibers of the Phrenic nerve go to which organ/structure

A

Diaphragm

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29
Q

Fibers of the Intercostal nerves go to which structures

A

Intercostal muscles

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30
Q

Respiratory effects of pain and emotion are innervated/ controlled by

A

The Limbic System and hypothalamus

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31
Q

Function of irritant receptors in the respiratory mucosa

A

stimulate vagal afferents to medulla, results in bronchoconstriction or coughing

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32
Q

Function of stretch receptors in airways

A

inflation reflex
excessive inflation triggers reflex
stops inspiration

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33
Q

Function of Chemoreceptors in Pulmonology

A

monitor blood pH, CO2 and O2 levels

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34
Q

Peripheral Chemoreceptors

A

Found in major blood vessels
Aortic Bodies
Carotid Bodies

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35
Q

Peripheral Chemoreceptors in the Aortic bodies

A

Signal the medulla via vagus nerves

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36
Q

Peripheral chemoreceptors in the Carotid bodies

A

Signals the medulla via Glossopharyngeal nerves

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37
Q

Central Chemoreceptors

A

Located in the medulla

Primarily monitor pH of Cerebrospinal Fluid (CSF)

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38
Q

Voluntary Control neural Pathways

A

motor cortex of frontal lobe of cerebrum sends impulses down corticospinal tracts to respiratory neurons in spinal cord, bypassing brainstem

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39
Q

Limitation of Voluntary Controls

A

blood CO2 and O2 limits cause automatic respiration

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40
Q

Atmospheric Pressure drives

A

Respiration

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41
Q

1 Atmosphere

A

760 mmHg

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42
Q

Intrapulmonary pressure

A

pressure is inversely proportional to volume for a given amount of gas, as volume , pressure  and as volume , pressure 

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43
Q

Pressure Gradients

A

difference between atmospheric and intrapulmonary pressure created by changes in volume thoracic cavity

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44
Q

As the Volume of the thoracic cavity increases,

A

the Visceral pleura cling to the Parietal pleura

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45
Q

Intrapulmonary Pressure

A

Lungs expand with Visceral pleura

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46
Q

Transpulmonary pressure

A

Intrapleural-Intrapulmonary pressure

not all pressure change in the pleural cavity is transferred to the lungs

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47
Q

Inflation is aided by

A

Warming of inhaled Air

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48
Q

How much air flows with a quiet breath

A

500 mL

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49
Q

During quiet breathing, expiration is achieved by

A

elasticity of lungs and thoracic cage

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50
Q

As the Volume of the Thoracic cavity decreases, what happens to the Intrapulmonary pressure?

A

Intrapulmonary Pressure increases and air is expelled

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51
Q

After inspiration, phrenic nerves continue to stimulate the diaphragm to produce

A

a braking action to elastic recoil

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52
Q

In forced Expiration, the internal intercostal muscles

A

Depress the ribs

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53
Q

In forced expiration, the abdominal muscles

A

Contract

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54
Q

In forced expiration, the abdominal muscles contract, resulting in

A

Increased abdominal pressure, which forces the diaphragm upward
Increased pressure on the Thoracic Cavity

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55
Q

Pneumothorax

A

Presence of Air in the pleural cavity

loss of negative intrapleural pressure allows lungs to recoil and collapse

56
Q

Atelectasis

A

Collapse of lung (or part of lung)

57
Q

Distensibility of Lungs

A

change in lung volume relative to a change in transpulmonary pressure

58
Q

What is the primary control over resistance to airflow?

A

Bronchiolar Diameter

59
Q

Bronchioconstriction is triggered by

A

airborne irritants, cold air, parasympathetic stimulation, histamine

60
Q

Bronchodilation

A

is stimulated by sympathetic nerves, epinephrine

61
Q

Alveolar Surface Tension

A

A Thin film of water is needed for gas exchange

62
Q

The thin film of water on the Alveolar surface

A

creates surface tension that acts to collapse alveoli and distal bronchioles

63
Q

Pulmonary Surfactant (great Alveolar Cells)

A

decreases surface tension

64
Q

Premature infants that lack surfactant suffer from

A

respiratory distress syndrome

65
Q

Dead Air

A

fills conducting division of airway, cannot exchange gases

66
Q

Anatomic dead space

A

Conducting Division of Airway

67
Q

Physiologic dead space

A

sum of anatomic dead space and any pathological alveolar dead space

68
Q

Alveolar ventilation rate

A

air that ventilates alveoli X respiratory rate

directly relevant to ability to exchange gases

69
Q

Spirometer

A

Measures Ventilation

70
Q

tidal volume

A

volume of air in one quiet breath

71
Q

inspiratory reserve volume

A

air in excess of tidal inspiration that can be inhaled with maximum effort

72
Q

expiratory reserve volume

A

air in excess of tidal expiration that can be exhaled with maximum effort

73
Q

residual volume

A

(keeps alveoli inflated)

air remaining in lungs after maximum expiration

74
Q

Vital Capacity

A

total amount of air that can be exhaled with effort after maximum inspiration

75
Q

What does Vital Capacity assess

A

strength of thoracic muscles and pulmonary function

76
Q

Inspiratory Capacity

A

maximum amount of air that can be inhaled after a normal tidal expiration

77
Q

Functional residual capacity

A

amount of air in lungs after a normal tidal expiration

78
Q

Total lung capacity

A

maximum amount of air lungs can hold

79
Q

Forced expiratory volume (FEV)

A

% of vital capacity exhaled/ time

healthy adult - 75 to 85% in 1 sec

80
Q

Peak flow

A

maximum speed of exhalation

81
Q

Minute respiratory volume (MRV)

A

TV x respiratory rate, at rest 500 x 12 = 6 L/min

maximum: 125 to 170 L/min

82
Q

As age decreases What happens to lung compliance

A

Lung compliance decreases, respiratory muscles weaken

83
Q

Exercise

A

maintains strength of respiratory muscles

84
Q

Body size in regards to lung volume and capacity

A

proportional, big body/large lungs

85
Q

Restrictive disorders

A

Decrease compliance and Vital Capacity

86
Q

Obstructive disorders

A

interfere with airflow, expiration requires more effort or less complete

87
Q

Air-Water Interface

A

Important for gas exchange between air in lungs and blood in capillaries

88
Q

Gasses Diffuse

A

Down their concentration Gradient

89
Q

Henry’s law

A

amount of gas that dissolves in water is determined by its solubility in water and its partial pressure in air

90
Q

Factors affecting Gas exchange

A

Membrane Thickness
Membrane Surface Area
Ventilation-Perfusion Coupling

91
Q

Ventilation-Perfusion Coupling

A

areas of good ventilation need good perfusion (vasodilation)

92
Q

Membrane surface area

A

100 ml blood in alveolar capillaries, spread over 70 m2

93
Q

Oxygen concentration in arterial blood

A

20 ml/dl

  1. 5% bound to hemoglobin
  2. 5% dissolved
94
Q

Oxygen Binding to hemoglobin

A

each heme group of 4 globin chains may bind O2
oxyhemoglobin (HbO2 )
deoxyhemoglobin (HHb)

95
Q

Oxyhemoglobin dissociation curve

A

relationship between hemoglobin saturation and PO2 is not a simple linear one

after binding with O2, hemoglobin changes shape to facilitate further uptake (positive feedback cycle)

96
Q

Carbon dioxide transported as Carbonic Acid

A

carbonic acid - 90%

CO2 + H2O →H2CO3 → HCO3- + H+

97
Q

Carbon Dioxide Transported as carbaminohemoglobin

A

carbaminohemoglobin (HbCO2)

5% binds to amino groups of Hb (and plasma proteins)

98
Q

Carbon Dioxide Transported as a Gas

A

As dissolved gas - 5%

99
Q

What are the 3 ways carbon dioxide is transported?

A

Carbonic Acid
carbaminohemoglobin
Dissolved Gas

100
Q

Alveolar exchange of CO2

A

carbonic acid - 70%
carbaminohemoglobin - 23%
dissolved gas - 7%

101
Q

Chloride Shift

A

Keeps reaction proceeding, exchanges HCO3- for Cl- (H+ Binds to Hemoglobin)

102
Q

CO2 Loading

A

Carbonic Anhydrase in RBC Catalyzes

CO2 + H2O →H2CO3 → HCO3- + H+

103
Q

O2 Unloading

A

H+ binding to HbO2 lowers its affinity for O2
Hb arrives 97% saturated, leaves 75% saturated - venous reserve
utilization coefficient
amount of oxygen Hb has released 22%

104
Q

Alveolar Gas Exchange reactions are the opposite of

A

Systemic Gas Exchange

105
Q

CO2 Unloading

A

As Hemoglobin loads O2, its affinity for H+ Decreases, H+ Dissociates from Hb and Bind with HCO3-
CO2+ H2O

106
Q

Reverse Chloride Shift

A

HCO3- diffuses back into RBC in exchange for Cl- ; Free CO2 Generated diffuses into alveolus to be exhaled

107
Q

Factors that affect O2 Unloading

A

Ambient PO2
Temperature
Bohr Effect
Biphosphoglycerate

108
Q

Ambient PO2 Affect on O2 Unloading

A

Active tissue has decreased PO2, and O2 is released

109
Q

Temperature affect on O2 Unloading

A

Active tissue has an increased temp and O2 is released

110
Q

Bohr effect

affect on O2 Unloading

A

Active tissue has an increase in CO2, which lowers Ph, (Muscle burn), and O2 Is released

111
Q

Biphosphoglycerate (BPG) affect on O2 Unloading

A

RBCs produce BPG which binds to Hemoglobin; O2 is released

112
Q

What would be the effect of an increased Body Temp (Fever), TH, GH, Testosterone, or Epinephrine?

A

All Raise BPG and cause O2 Unloading (an increased metabolic rate will require Oxygen)

113
Q

Factors that affec CO2 Loading

A

Haldane Effect

114
Q

Haldane Effect

A

Low Level of HbO2(as in active tissue) enables blood to transport more CO2)
HbO2 does not bind CO2 as well as Deoxyhemoglobin (HHb)
HHb binds more H+ than HbO2

115
Q

Haldane effect reaction

A

as H+ is removed this shifts the
CO2 + H2O —–> HCO3- + H+
reaction to the right

116
Q

Blood Chemistry and Respiration Rhythm

A

Rate and Depth of breathing is adjusted to maintain levels of pH, PCO2, and PO2

117
Q

Effects of Hydrogen Ions

A 
pH of CSF
Respiratory Acidosis
Hypercapnia
Respiratory Alkalosis
ph Imbalances
118
Q

What is the most powerful Respiratory Stimulus (in regards to Hydrogen Ions)

A

pH of CSF (Cerebrospinal Fluid)

119
Q

Cerebrospinal Fluid

A

CSF

120
Q

Respiratory Acidosis

A

acidosis (pH < 7.35) caused by failure of pulmonary ventilation

121
Q

HyperCapnia

A

PCO2 > 43 mmHg
CO2 easily crosses blood-brain barrier
in CSF the CO2 reacts with water and releases H+
central chemoreceptors strongly stimulate inspiratory center

122
Q

Blowing Off CO2

A

pushes reaction to the left CO2 (expired) + H2O

123
Q

Respiratory Alkalosis

A

(pH > 7.45)
hypocapnia: PCO2 < 37 mmHg
Hypoventilation (Increased CO2), pushes reaction to the right Increased CO2 + H2O —–>H2CO3——>HCO3- + H+
H+ (increases acid), lowers pH to normal

124
Q

Effects of pH Imbalances

A

Metabolic Causes
Uncontrolled Diabetes Mellitus
-Fat Oxidation causes ketoacidosis; May be compensated for by Kussmaul Respiration (Deep Rapid Breathing)

125
Q

Effects of Carbond Dioxide

A

Indirect affects on Respiration (Ph)
Direct Effects: increased CO2 may directly stimulate peripheral chemoreceptors and trigger increased ventilation more quickly than central chemoreceptors

126
Q

Effects of Oxygen

A

Usually Little Effect
Chronic Hypoxemia; PO2<60 mmHg, can significantly stimulate ventilation
-emphysema
-High Altitudes for several days

127
Q

Causes of Hypoxemic Hypoxia

A

due to inadequate pulmonary gas exchange

high altitudes, drowning, aspiration, respiratory arrest, degenerative lung diseases, CO poisoning

128
Q

Causes of Ischemic Hypoxia

A

Inadequate Circulation

129
Q

Causes of Anemic Hypoxia

A

Anemia

130
Q

Causes of Histotoxic Hypoxia

A

Metabolic Poison (Cyanide)

131
Q

Signs of Hypoxia

A

Blueness of Skin

132
Q

Primary Effects of Hypoxia

A

tissue necrosis, organs with high metabolic demands affected first

133
Q

Oxygen Toxicity

A

pure O2 breathed at 2.5 atm or greater

134
Q

Effects of Oxygen Toxicity

A

generates free radicals and H2O2
destroys enzymes
damages nervous tissue
leads to seizures, coma, death

135
Q

Hyperbaric Oxygen

A

formerly used to treat premature infants, caused retinal damage, discontinued

Human Physiology 2234 (10 decks)

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